Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 5, Issue 4 | Original Article | Open Access
Shaili Priyamvada*
Shaili Priyamvada1*, Hukam Singh2, Avinash Goswami3
1Senior Consultant Otorhinolaryngology, Dharamshila Narayana Hospital, New Delhi, India
2Department of Otorhinolaryngology, Government Institute of Medical Sciences, Greater Noida, India
3Consultant Neurologist, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
*Correspondence to: Shaili Priyamvada
Fulltext PDFChronic otitis media represents one of the most common diseases of the middle ear cleft. It is classified into mucosal, squamosal and healed otitis media. Based upon whether the ear discharge is present it is further sub-divided into active and inactive type of mucosal or squamosal disease [1]. In mucosal type of COM chances of complications are less, whereas squamosal disease i.e. cholesteatoma is often associated with ostetitis, bone erosions, granulation tissue, marginal perforation and risk of complications is high. It affects people of all age groups and both genders.
Chronic otitis media continues to be an important public health problem despite significant advances in medical science in south-east Asian countries. It is the commonest preventive and curable cause of hearing loss. The definitive treatment is tympanomastoid exploration. The aim of surgery is to eliminate the infection, achieve dry ear, and prevent reinfection by closure of tympanic membrane perforation and to restore hearing. Chronic otitis media is multifactorial disease; causes include recurrent and long standing middle ear infection, inflammation, eustachian tube dysfunction, nasal allergy and trauma.
At present otolaryngologists around the globe are not using tympanomastoidectomy as a routine procedure in the treatment of mucosal type of chronic otitis media. There is controversy about the role of mastoidectomy along with tympanic membrane repair in cases of mucosal type of chronic otitis media. There are different studies on this topic with variable opinions regarding role of cortical mastoidectomy in mucosal type of COM [2-5]. The are many factors which affect the successful outcome of surgery, it includes the type of mastoid pneumatization and presence of inflammatory disease in the mastoid air cells. Holmquist and Bergstorm in 1978 observed that well aerated mastoid is a pre-requisite for a ventilated middle ear and long term success [6].
The term “Tympanoplasty” was first used by Wullstein in 1953 [7]. Various grafting materials has been used. Temporalis fascia is the most commonly used graft material. Other grafting materials such as vein graft, fat, perichondrium, placental membrane have been used. Glasscock and Shambaugh used full thickness skin graft, while Wullstein and Zollner used split thickness skin grafts [8]. The most common approaches for Tympanoplasty are end-aural, post-aural and per-meatal. Endaural approach gives better exposure of posterior part, while post-aural approach give better exposure of anterior part of tympanic membrane. For small perforation with wide canal, per-meatal approach is applied.
We studied 60 patients who were diagnosed with mucosal type of chronic otitis media and they underwent tympanoplasty and cortical mastoidectomy surgery under general anaesthesia for the success rate in terms of graft uptake and disease free ear.
Chronic otitis media, mucosal type COM, Mastoidectomy
Shaili Priyamvada, Hukam Singh, Avinash Goswami. Role of Cortical Mastoidectomy in Mucosal Type of Chronic Otitis Media: An Institutional Study. Annal of Otol Head and Neck Surg. 2026;5(4):1-3.